Collections Representative

SGA•Weatherford, TX

10h•$22•Remote

About The Position

Software Guidance & Assistance, Inc., (SGA), is searching for a Collections Representative for a Contract assignment with one of our premier Healthcare clients in Weatherford, TX . This is a work from home (WFH) opportunity. The successful applicant must live within the Greater DFW area and be available to come to the office for equipment pickup, office meetings, and training. Additional details regarding WFH will be discussed as part of the interview process.

Requirements

2 years experience in medical claims recovery and/or collections required
Work requires experience in Medical Billing, AccountsReceivables, and/or Collections within a healthcare or insuranceenvironment.
Work requires good organizational, flexibility and analytical skills when resolving more complex unpaid claims.
Work requires knowledge of billing and/or collections and regulations.
Work requires understanding of the requirements of Medicaid, Medicare and insurance billing.
Work requires a self-starter, with ability to work well as part of a team and independently.
Work requires ability to communicate effectively with patients, insurance companies, clinical staff and management.
Work requires ability to handle large volumes of work.
Work requires ability to work in a fast paced, production oriented environment.
Work requires excellent customer service skills.
Work requires one to exhibit excellent work ethics and commitment to job responsibilities.
Work requires one to possess a professional and courteousdemeanor while being assertive and confident in their collectionefforts.
Work requires one to possess quick and accurate alpha/numeric data entry skills.
Work requires presence of a positive image that reflects well on the organization.
Work requires strong written and verbal communication skills.

Nice To Haves

Associate's Degree
Work requires knowledge of CMS 1500, ICD-9, and CPT coding is preferred.

Responsibilities

The successful candidate will review, research, and resolveclaim denials and appeals for various insurance companies whileidentifying payment trends in an effort to maximize collections.
Capable of reviewing Explanation of Benefits (EOB) from payors to determine how the claims were managed.
Contacting insurance carriers to check on the status of claims, appeals, and insurance verification.
Knowledgeable with payors including Managed Care, Commercial, Medicare, and Medicaid
Preparing/Submitting appeals related to denied services
Analyze payer denials by denial groupers and submit appeals.
Contact patients and/or third party payers to resolve outstanding insurance balances and underpaid claims.
Make necessary adjustments as required by plan reimbursement.
Functions as a liaison between clinical departments and MSRDP management team.
Completes special projects as assigned.
Performs other duties as assigned.